This document discusses strategies for leading large scale change. It notes that the greatest danger is not micro-managing but "macro-leading". It also discusses that the 3% rule appears true for social media, where 3.3% of tweeters accounted for 85% of retweets in health and healthcare. The document lists who may typically make change happen through formal leadership roles but notes most influencers are actually "mavericks and rebels" like deviants who do things differently and the hyper-connected who spread behaviors at scale. It emphasizes engaging investors in change rather than just seeking buy-in.